PLEASE FILL THIS FORM TO JOIN BCP

1) SURNAME / SEFANE ...........               

(2) NAME /LEINA  .......................                           

(3) GENDER /SEX / BONG  ........           

(4) DATE OF BIRTH / MATSALO  ..... 

(5) ID / OMANG NO.........................                           

(6) WARD/Kgaolwana ya Bokhanselara........  

(7) KGOTLANA MO MOTSENG.........................          

(8) CONTITUENCY / KGAOLO.........................           

(9) REGION / KGAOLO-KGOLO.......................          

(10) HOME VILLAGE..........................................                            

(11) CELL / MOBILE .........................................                           

(12) TEL (H) TEL(W) .......................................                            

(13) EMAIL ADDRESS.....................................                             

(14) PLOT NUMBER / NOMORO YA BONNO.......     

(15) POSTAL ADDRESS .........................................                                

(16) OCCUPATION...............................                                           

(17) QUALIFICATIONS/ SKILLS/TALENTS..........            

(18) Other Organization That You Belong To.........         

(19) Any Person you recommend to join BCP (Name & Contacts)....

(20) Fill in Next of Kin and Contacts ..........                      

(21) TYPE OF MEMBERSHIP  ........       

 NOTE:

(a) Special Life Membership  P1 000

(b) Life Membership  P200

(c) Renewable Membership (P10) for five years